Evaluation of shoulder laxity

An understanding of the anatomy and biomechanical features of the glenohumeral joint is necessary when understanding the concept of shoulder laxity. Glenohumeral laxity is a normal feature of shoulder motion, but only when that laxity becomes excessive does instability occur. The clinician must use the history and physical examination to distinguish normal from pathological laxity. Several examination techniques are commonly used to evaluate anterior, posterior, inferior, and multidirectional shoulder laxity. It has become appreciated that subluxation of the shoulder upon physical examination does not necessarily mean that the shoulder is clinically or symptomatically unstable. This paper reviews the current techniques to evaluate shoulder laxity and discusses the interpretation of these examinations as they relate to normal and pathological laxities.